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4. Surgical Removal of a Long-Forgotten, Retained Intravascular Foreign Body: A Case Report and Literature Review

Author

Dimitrios A. Chatzelas, Apostolos G. Pitoulias, Georgios V. Tsamourlidis, Theodosia N. Zampaka, Vasiliki-Elisavet P. Stratinaki, Ioanna I. Kiose, Anastasios G. Potouridis, Maria D. Tachtsi, and Georgios A. Pitoulias

Subjects
central venous catheterization, foreign bodies, delayed diagnosis, surgery, Diseases of the blood and blood-forming organs, RC633-647.5, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Intravascular foreign body embolization is a potential complication of any vascular operation. Placement of a central venous catheter (CVC) is a common procedure, especially during surgery, hemodialysis, or in critically ill patients. The complete loss of the introducing guidewire into the circulation is a rare complication, with the majority of cases identified immediately or shortly after the procedure. We report an unusual case of an 82-year-old male with a misplaced CVC guidewire, extending from the right common femoral vein (CFV) to the superior vena cava, that was found incidentally 2 years after internal jugular vein cannulation during colorectal surgery. The patient was asymptomatic at the time, without any signs of deep vein thrombosis or post-thrombotic syndrome. Surgical extraction of the guidewire was successfully performed, under local anesthesia, through venotomy of the right CFV. Proper education and advanced awareness are advised in order to minimize the risk of this avoidable complication.

Published
2024
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5. Elective Surgical Repair of Popliteal Artery Aneurysms with Posterior Approach vs. Endovascular Exclusion: Early and Long Term Outcomes of Multicentre PARADE Study

Author

Adami, Daniele, Andreini, Marco, Scarati, Valentina, Pulli, Raffaele, Pratesi, Carlo, Fargion, Aaron Thomas, Biancofiore, Brigida, Grego, Franco, Squizzato, Francesco, Piazza, Michele, Colacchio, Elda Chiara, Ruffino, Maria Antonella, Robaldo, Alessandro, Bertoglio, Luca, Baggi, Paolo, Verrengia, Apollonia, Ippoliti, Arnaldo, Oddi, Fabio Massimo, Marchetti, Andrea Ascoli, Di Marzo, Luca, Mansour, Wassim, Di Girolamo, Alessia, Marzano, Antonio, Kotelis, Drosos, Zielasek, Christian, Papazoglou, Dimitrios D., Perkmann, Reinhold, Pipitone, Marco D., Taurino, Maurizio, Sirignano, Pasqualino, Romano, Elisa, Lenti, Massimo, Isernia, Giacomo, Simonte, Gioele, Fino, Gianluigi, Veraldi, Gian F., Mezzetto, Luca, Angiletta, Domenico, Zacà, Sergio, Ringold, Margot, Sodero, Francesca, Pitoulias, Georgios, Chatzelas, Dimitrios A., Traina, Luca, Zenunaj, Gladiol, Khashram, Manar, Ghamri, Nusr, Lovelock, Thomas M., D’Elia, Marcello, Hamdy, Ayman, Biasi, Lukla, Sanjay, Patel, Lepidi, Sandro, D’Oria, Mario, Badalamenti, Giovanni, Ruggiero, Massimo G., Desantis, Claudio, Filippi, Federico, Anzaldi, Manfredi, Siani, Andrea, Accrocca, Federico, Gabrielli, Roberto, Bartoli, Stefano, Martelli, Massimiliano, Micheli, Raimondo, Gugliotta, Maria C., Besias, Nikolaos, Roditis, Konstantinos, Usai, Marco V., Tshomba, Yamume, Natola, Marco, Scurto, Lucia, Korosoglou, Grigorios, Schoefthaler, Christoph, Jehn, Amila, Davies, Robert, Maritati, Gabriele, Ghosh, Shantonu Kumar, Donas, Konstantinos P., Pitoulias, Apostolos G., Avranas, Konstantinos, Bafile, Gennaro, Martelli, Eugenio, Cavallo, Eduardo, Caronno, Roberto, Alberti, Aldo, Volpe, Pietro, Massara, Mafalda, Alberti, Antonino, Zappadu, Sara, Troisi, Nicola, Bertagna, Giulia, Saratzis, Athanasios, Zayed, Hany, Torsello, Giovanni B., Dorigo, Walter, Antonello, Michele, Prouse, Giorgio, Bonardelli, Stefano, and Berchiolli, Raffaella

Published
2024
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6. Can Routine Investigation for Occult Pulmonary Embolism Be Justified in Patients with Deep Vein Thrombosis?

Author

Dimitrios A. Chatzelas, Apostolos G. Pitoulias, Vangelis Bontinis, Theodosia N. Zampaka, Georgios V. Tsamourlidis, Alkis Bontinis, Anastasios G. Potouridis, Maria D. Tachtsi, and Georgios A. Pitoulias

Subjects
venous thrombosis, pulmonary embolism, thromboembolism, computed tomography angiography, diagnosis, Diseases of the blood and blood-forming organs, RC633-647.5, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Purpose: This study aims to investigate whether routine screening for silent pulmonary embolism (PE) can be justified in patients with deep vein thrombosis (DVT). Materials and Methods : We retrospectively analyzed the medical records of 201 patients with lower-extremity DVT admitted to the vascular surgery department of a single tertiary university center between 2019 and 2023. All patients underwent clinical evaluation, basic laboratory exams, a whole-leg colored duplex ultrasound, and a computed tomography pulmonary angiography (CTPA), to screen for an occult, underlying PE. Results : The overall incidence of silent PE was 48.8%. The median admission D-dimer level was significantly higher in patients with silent PE than in those without PE (9.60 vs. 5.51 mg/L, P=0.001). A D-dimer value ≥5.14 mg/L was discriminant for predicting silent PE, with a sensitivity of 68.2% and a specificity of 59.3%. Silent PE was significantly more common on the right side, with the embolus located at the main pulmonary, lobar, segmental, and subsegmental arteries in 29.6%, 32.7%, 20.4%, and 17.3%, respectively. A higher incidence of occult PE was observed in patients with iliofemoral DVT (P=0.037), particularly when the thrombus extended to the inferior vena cava (P=0.003). Moreover, iliofemoral DVT was associated with a larger size and a more proximal location of the embolus (P=0.041). Multivariate logistic regression showed that male sex (odds ratio [OR]=2.46, 95% confidence interval [CI]: 1.39-3.53; P=0.026), cancer (OR=2.76, 95% CI: 1.45-4.07; P=0.017), previous venous thromboembolism (VTE) history (OR=2.67, 95% CI: 1.33-4.01; P=0.022), D-dimer value ≥5.14 mg/L (OR=2.24, 95% CI: 1.10-3.38; P=0.033), iliofemoral DVT (OR=2.13, 95% CI: 1.19-3.07; P=0.041), and thrombus extension to the IVC (OR=2.95, 95% CI: 1.43-4.47; P=0.009) served as independent predictors for silent PE. Conclusion : A high incidence of silent PE was observed in patients with lower-extremity DVT. Screening of patients with DVT who have the aforementioned predictive risk factors using CTPA for silent PE may be needed and justified for the efficient management of VTE and its long-term complications.

Published
2024
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7. Endosutured Aneurysm Repair of Abdominal Aortic Aneurysms with Short Necks Achieves Acceptable Midterm Outcomes—Results from the Peru Registry

Author

Schuurmann, Richte, Zúñiga, Claudio Gandarias, Badawy, Ayman, Bastianon, Martina, Ferrer, Miguel, Fontanini, Daniele Mariastefano, Reyes Valdivia, Andrés, Oikonomou, Kyriakos, Milner, Ross, Pitoulias, Apostolos, Reijnen, Michel M.P.J., Pfister, Karin, Tinelli, Giovanni, Csobay-Novák, Csaba, Pratesi, Giovanni, Ferreira, Luis Mariano, de Vries, Jean-Paul P.M., and Chaudhuri, Arindam

Published
2024
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8. Endovascular Repair of a Failed Nellix Endograft Proximal Sealing Zone Using the Altura Stent-Graft: A Case Report and Literature Review

Author

Dimitrios A. Chatzelas, Apostolos G. Pitoulias, Georgios V. Tsamourlidis, Theodosia N. Zampaka, Anastasios G. Potouridis, Maria D. Tachtsi, and Georgios A. Pitoulias

Subjects
abdominal aortic aneurysm, endovascular aneurysm repair, complications, follow up study, case reports, Diseases of the blood and blood-forming organs, RC633-647.5, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Endovascular aortic aneurysm sealing (EVAS) with the Nellix endograft was initially considered a groundbreaking and acceptable alternative to conventional endovascular aortic aneurysm repair, with encouraging initial results. However, long-term follow-up has revealed a high incidence of endograft-related complications, such as caudal migration and type Ia endoleaks, indicating the need for reintervention. Managing failed EVAS remains challenging and is an ongoing topic of discussion, especially for high-risk patients. We describe a 70-year-old female who initially underwent EVAS with a Nellix endograft and presented after 5 years of follow-up with caudal endograft migration and a type Ia endoleak. The patient was treated with endovascular implantation of an Altura stent-graft, a relatively new low-profile device with a similar double stent configuration. Device migration and endoleaks were undetectable at 12 months of follow-up, suggesting that the Altura might offer a safe and efficient approach in cases of Nellix proximal failure.

Published
2023
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10. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

collaborative, The VERN COVER study, Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Maadany, Faraj Al, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M, Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH, Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A, Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Jácome, Ana Filipa Campos, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Reis, Paulo Eduardo Ocke, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H, Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, and Corless, Kevin

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Dentistry, Pediatric Research Initiative, Prevention, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, VERN COVER study collaborative, AAA, COVID-19, PAD, Survey, Vascular surgery, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectiveTo document the recovery of vascular services in Europe following the first COVID-19 pandemic peak.MethodsAn online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume.ResultsThe impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence.ConclusionCentres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022

11. Glycolytic pyruvate kinase moonlighting activities in DNA replication initiation and elongation

Author

Horemans, Steff, Pitoulias, Matthaios, Holland, Alexandria, Soultanas, Panos, and Janniere, Laurent

Subjects
Quantitative Biology - Molecular Networks
Abstract

Cells have evolved a metabolic control of DNA replication to respond to a wide range of nutritional conditions. Accumulating data suggest that this poorly understood control depends, at least in part, on Central Carbon Metabolism (CCM). In Bacillus subtilis , the glycolytic pyruvate kinase (PykA) is intricately linked to replication. This 585 amino-acid-long enzyme comprises a catalytic (Cat) domain that binds to phosphoenolpyruvate (PEP) and ADP to produce pyruvate and ATP, and a C-terminal domain of unknown function. Interestingly, the C-terminal domain termed PEPut interacts with Cat and is homologous a domain that, in other metabolic enzymes, are phosphorylated at a conserved TSH motif at the expense of PEP and ATP to drive sugar import and catalytic or regulatory activities. To gain insights into the role of PykA in replication, DNA synthesis was analyzed in various Cat and PEPut mutants grown in a medium where the metabolic activity of PykA is dispensable for growth. Measurements of replication parameters ( ori/ter ratio, C period and fork speed) and of the pyruvate kinase activity showed that PykA mutants exhibit replication defects resulting from side chain modifications in the PykA protein rather than from a reduction of its metabolic activity. Interestingly, Cat and PEPut have distinct commitments in replication: while Cat impacts positively and negatively replication fork speed, PEPut stimulates initiation through a process depending on Cat-PEPut interaction and growth conditions. Residues binding to PEP and ADP in Cat, stabilizing the Cat-PEPut interaction and belonging to the TSH motif of PEPut were found important for the commitment of PykA in replication. In vitro , PykA affects the activities of replication enzymes (the polymerase DnaE, helicase DnaC and primase DnaG) essential for initiation and elongation and genetically linked to pykA . Our results thus connect replication initiation and elongation to CCM metabolites (PEP, ATP and ADP), critical Cat and PEPut residues and to multiple links between PykA and the replication enzymes DnaE, DnaC and DnaG. We propose that PykA is endowed with a moonlighting activity that senses the concentration of signaling metabolites and interacts with replication enzymes to convey information on the cellular metabolic state to the replication machinery and adjust replication initiation and elongation to metabolism. This defines a new type of replication regulator proposed to be part of the metabolic control that gates replication in the cell cycle.

Published
2020

13. The link between central carbon metabolism and replication in Bacillus subtilis

Author

Pitoulias, Matthaios G.

Subjects
572, QR 75 Bacteria. Cyanobacteria
Abstract

It is a common observation that the growth rates of cells, specifically carbon metabolism is inextricably linked with replication. While progress has been made into both fields of metabolism and replication individually, the underlying mechanism demonstrating how these two pathways intercept is yet to be discovered. Recent genetic data from our collaborators indicate a coupling between replication and the lower part of glycolysis. Specifically, the spotlight is under the metabolic PykA/CcpN/YqfL cascade and the replication regime, referring to the helicase DnaC, the helicase loader DnaI, the primase DnaG and the polymerase DnaE. We tried to investigate the above hypothesis using biochemical and biophysical in vitro approaches such as Electrophoretic Mobility Shift Assays (EMSAs), Helicase Unwinding and Primer Extension assays, Mass Spectrometry and Surface Plasmon Resonance (SPR). Most importantly, our data revealed a functional interplay between the Pyruvate kinase PykA and the lagging strand polymerase DnaE through a series of primer extension assays. Additionaly, we discovered novel functional effects in vitro mediated by other metabolic proteins including PykA on the activities of the helicase DnaC, and also a reversal of the DnaG-mediated stimulation of the DnaC helicase activity.

Published
2020

16. Von Gierke Disease (Glycogen Storage Disease Type I) and Life-Threatening Abdominal Aortic Aneurysm: A Case Report of an Extremely Rare Condition

Author

Apostolos G. Pitoulias, Nizar Abu Bakr, Majid Kazemtash, Firouza Dahi, Michael Schütz, and Konstantinos P. Donas

Subjects
glycogen storage disease, von gierke disease, abdominal aortic aneurysm, open repair, Diseases of the blood and blood-forming organs, RC633-647.5, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Von Gierke disease, also known as glycogen storage disease type I, co-existent with an abdominal aortic aneurysm (AAA), is an extremely rare combination of diseases that requires challenging therapeutic measures. We present, for the first time in literature, the case of a 62-year-old female with von Gierke disease who required open surgical repair of an AAA with challenging neck anatomy outside of instructions for use of endovascular repair. Even though the surgical risks for life-threatening complications, such as pancreatitis, metabolic acidosis, and kidney failure, were high, the 6-month postoperative course was uneventful. Despite the invasiveness of the treatment, surgery to treat the AAA was safe and effective. Further data is needed to draw robust conclusions about the treatment of choice for those patients with diseases in co-existence with AAAs.

Published
2023
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21. Ferric quinate (QPLEX) inhibits the interaction of major outer membrane protein (MOMP) with the Lewis b (Leb) antigen and limits Campylobacter colonization in broilers

Author

Jennifer C. Okoye, Alexandria Holland, Matthaios Pitoulias, Vasileios Paschalis, Artem Piddubnyi, Osman A. Dufailu, Thomas Borén, Neil J. Oldfield, Jafar Mahdavi, and Panos Soultanas

Subjects
major outer membrane protein (MOMP), Campylobacter, broilers, iron chelates, Lewis b (Leb) antigen, gastrointestinal, Microbiology, QR1-502
Abstract

Campylobacter jejuni colonizes hosts by interacting with Blood Group Antigens (BgAgs) on the surface of gastrointestinal epithelia. Genetic variations in BgAg expression affects host susceptibility to C. jejuni. Here, we show that the essential major outer membrane protein (MOMP) of C. jejuni NCTC11168 binds to the Lewis b (Leb) antigen on the gastrointestinal epithelia of host tissues and this interaction can be competitively inhibited by ferric quinate (QPLEX), a ferric chelate structurally similar to bacterial siderophores. We provide evidence that QPLEX competitively inhibits the MOMP-Leb interaction. Furthermore, we demonstrate that QPLEX can be used as a feed additive in broiler farming to significantly reduce C. jejuni colonization. Our results indicate that QPLEX can be a viable alternative to the preventative use of antibiotics in broiler farming to combat C. jejuni infections.

Published
2023
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23. Pyruvate kinase, a metabolic sensor powering glycolysis, drives the metabolic control of DNA replication

Author

Steff Horemans, Matthaios Pitoulias, Alexandria Holland, Emilie Pateau, Christophe Lechaplais, Dariy Ekaterina, Alain Perret, Panos Soultanas, and Laurent Janniere

Subjects
Replication timing, Central carbon metabolism, Glycolytic enzymes, Replication enzymes, Cell cycle, Allosteric regulation, Biology (General), QH301-705.5
Abstract

Abstract Background In all living organisms, DNA replication is exquisitely regulated in a wide range of growth conditions to achieve timely and accurate genome duplication prior to cell division. Failures in this regulation cause DNA damage with potentially disastrous consequences for cell viability and human health, including cancer. To cope with these threats, cells tightly control replication initiation using well-known mechanisms. They also couple DNA synthesis to nutrient richness and growth rate through a poorly understood process thought to involve central carbon metabolism. One such process may involve the cross-species conserved pyruvate kinase (PykA) which catalyzes the last reaction of glycolysis. Here we have investigated the role of PykA in regulating DNA replication in the model system Bacillus subtilis. Results On analysing mutants of the catalytic (Cat) and C-terminal (PEPut) domains of B. subtilis PykA we found replication phenotypes in conditions where PykA is dispensable for growth. These phenotypes are independent from the effect of mutations on PykA catalytic activity and are not associated with significant changes in the metabolome. PEPut operates as a nutrient-dependent inhibitor of initiation while Cat acts as a stimulator of replication fork speed. Disruption of either PEPut or Cat replication function dramatically impacted the cell cycle and replication timing even in cells fully proficient in known replication control functions. In vitro, PykA modulates activities of enzymes essential for replication initiation and elongation via functional interactions. Additional experiments showed that PEPut regulates PykA activity and that Cat and PEPut determinants important for PykA catalytic activity regulation are also important for PykA-driven replication functions. Conclusions We infer from our findings that PykA typifies a new family of cross-species replication control regulators that drive the metabolic control of replication through a mechanism involving regulatory determinants of PykA catalytic activity. As disruption of PykA replication functions causes dramatic replication defects, we suggest that dysfunctions in this new family of universal replication regulators may pave the path to genetic instability and carcinogenesis.

Published
2022
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24. Endovascular Treatment of a Giant Renal Artery Aneurysm with High-Flow Renal Arteriovenous Malformation

Author

Apostolos G. Pitoulias, Georgios A. Pitoulias, Dimitrios A. Chatzelas, Theodosia Zampaka, Thomas E. Kalogirou, Anastasios Potouridis, Charalampos Loutradis, and Maria D. Tachtsi

Subjects
aneurysm, endovascular procedures, arteriovenous malformations, arteriovenous fistula, renal circulation, Diseases of the blood and blood-forming organs, RC633-647.5, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Renal artery aneurysms (RAAs) are rare lesions with a prevalence of less than 1% in the general population. Renal arteriovenous malformations (AVMs) are rare lesions with an estimated incidence of less than 0.04%. The coexistence of these two clinical entities is extremely rare and narrows the available treatment options by endovascular or open surgery. We describe a case of a giant symptomatic RAA type III, which was combined with a high-flow renal AVM in the right kidney. Using two vascular plugs, the RAA was excluded successfully. The perfusion of the right kidney’s lower pole was preserved by implantation of two covered stents in the inferior segmental renal artery.

Published
2022
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25. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Al Maadany, Faraj, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M., Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH., Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A., Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Campos Jácome, Ana Filipa, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Ocke Reis, Paulo Eduardo, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H., Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, Corless, Kevin, Ioannidis, Orestis, Friedrich, Oliver, Van Herzeele, Isabelle, Vijaynagar, Badri, Cohnert, Tina, Bell, Rachel, Moore, Hayley, Saha, Prakash, Gifford, Edward, Laine, Matti, Barkat, Adel, Karkos, Christos, Binti Safri, Lenny Suryani, Buitron, Gabriel, Del Castillo, Javier, Carrera, Paul, Salinas, Nilson, Biagioni, Rodrigo Bruno, Benites, Sergio, Mafla, César Andrés, Pian, Putera Mas, Albino, Pereira, Serrano, Ernesto, Marin, Andres, González, Marco, Foreroga, Marsha, Russo, Alejandro, Reyes, Andrés, Guglielmone, Daniel, Grillo, Lorena, Flumignan, Ronald, Palones, Francisco Gomez, Silveira, Pierre Galvagni, Ramely, Rosnelifaizur Bin, Edeiken, Sara, Chetter, Ian, Green, Lucy, Sudarsanam, Abhilash, Lyons, Oliver, Lemmon, Gary, Neville, Richard, Castelli, Mariano, Hinojosa, Carlos A., Carvajal, Rubén Rodríguez, Rivera, Aksim, Wong, Peng, Drudi, Laura, Perkins, Jeremy, Sieunarine, Kishore, Attia, Doaa, Atef, Mahmoud, Eftychios, Lostoridis, Weaver, Fred, Ren, Leong Chuo, Alomari, Mohannad, Jamjoom, Reda, Aljarrah, Qusai, Abbas, Ayman, Alomran, Faris, Kumar, Ambrish, Altoijri, Abdulmajeed, ElSanhoury, Kareem T., Alhumaid, Ahmed, Fekry, Tamer, Sekhar, Raghuram, Theodoridis, Panagiotis, Panagiotis, Theodoridis, Roditis, Konstantinos, Tsiantoula, Paraskevi, Antoniou, Afroditi, Soler, Raphael, Hasemaki, Natasha, Baili, Efstratia, Mpaili, Eustratia, Huasen, Bella, Wallace, Tom, Duncan, Andrew, Metcalfe, Matthew, Mannoia, Kristyn, Bechara, Carlos F., Tsilimparis, Nikolaos, Aranson, Nathan, Riding, David, Palena, Mariano, McDonnell, Ciarán, Mouawad, Nicolas J., Banegas, Shonda, Rossi, Peter, Oshodi, Taohid, Diaz, Rodney, Afifi, Rana, Dindyal, Shiva, Thapar, Ankur, Kordzadeh, Ali, Pullas, Gonzalo, Lin, Stephanie, Davies, Chris, Darvall, Katy, Kodama, Akio, Gooneratne, Thushan, Gunawansa, Nalaka, Munoz, Alberto, Jie, Ng Jun, Bradley, Nicholas, Al-Jundi, Wissam, Meyer, Felicity, Lee, Cheong, Malina, Martin, Renton, Sophie, Lui, Dennis, Batchelder, Andrew, Oszkinis, Grzegorz, Freyrie, Antonio, Giordano, Jacopo, Saratzis, Nikolaos, Tigkiropoulos, Konstantinos, Kyriakos, Stavridis, Popov, Guriy, Cheema, Muhammad Usman, Lapolla, Pierfrancesco, Ling Patricia, Yih Chun, Ennab, Raed, Ullery, Brant W., Pasenidou, Ketino, Tam, Jacky, Sidel, Gabriel, Jayaprakash, Vivek Vardhan, Bennett, Lisa, Hardy, Simon, Davies, Emma, Baker, Sara, Wijesinghe, Lasantha, Tam, Adam, McCune, Ken, Chana, Manik, Lowe, Chris, Goh, Aaron, Powezka, Katarzyna, Kyrou, Ioanna, Altaf, Nishath, Harkin, Denis, Travers, Hannah, Cragg, James, sharif, Atif, Akhtar, Tasleem, Chávez, José Antonio, Ordonez, Claudia, Mazzurco, Martin, Choke, Edward, Asghar, Imran, Summerour, Virginia, Dunlop, Paul, Morley, Rachel, Hardy, Thomas, Bevis, Paul, Cuff, Robert, Stavroulakis, Konstantinos, Beropoulis, Efthymios, Argyriou, Angeliki, Loftus, Ian, Azhar, Bilal, Sheth, Sharvil, Usai, Marco Virgilio, Choudhry, Asad, Nicole, Kira, Boyle, Emily, Joyce, Doireann, Abdelaty Hassan, Mohammed Hassan, Saltiel, Alberto, Frahm-Jensen, Gert, Antoniou, George, Elhadi, Muhammed, Kimyaghalam, Ali, Malgor, Rafael, O'Banion, Leigh Ann, Telve, Diego, Isaak, Andrej, Schmidli, Jürg, McKevitt, Kevin, Siddiqui, Tam, Asciutto, Giuseppe, Floros, Nikolaos, Papadopoulos, George, Kafetzakis, Alexandros, Koutsias, Stylianos G., Nana, Petroula, Giannoukas, Athanasios, Kakkos, Stavros, Moulakakis, Konstantinos G., Shafique, Natasha, Jawien, Arkadiusz, Popplewell, Matthew, Imray, Chris, Abayasekara, Kumar, Rowlands, Timothy, Kuhan, Ganesh, Rajagopalan, Sriram, Jaipersad, Anthony, Sadia, Uzma, Kobe, Isaac, Mittapalli, Devender, Enemosah, Ibrahim, Behrendt, Christian-Alexander, Beck, Adam, Almudhafer, Muayyad, Ancetti, Stefano, Jacobs, Donald, Jayakumar, Priya, Malekpour, Fatemeh, Shalhub, Sherene, Keldiyorov, Boboyor, Simon, Meryl, Khashram, Manar, Rich, Nicole, Shepherd, Amanda, Meecham, Lewis, Doherty, Daniel, and Benson, Ruth A.

Published
2022
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26. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, and Daniel Doherty

Subjects
AAA, COVID-19, PAD, Survey, Vascular surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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30. Endosutured Aneurysm Repair of Abdominal Aortic Aneurysms with Short Necks Achieves Acceptable Midterm Outcomes—Results from the Peru Registry

Author

Reyes Valdivia, Andrés, Oikonomou, Kyriakos, Milner, Ross, Pitoulias, Apostolos, Reijnen, Michel M.P.J., Pfister, Karin, Tinelli, Giovanni, Csobay-Novák, Csaba, Pratesi, Giovanni, Ferreira, Luis Mariano, de Vries, Jean-Paul P.M., Chaudhuri, Arindam, Schuurmann, Richte, Zúñiga, Claudio Gandarias, Badawy, Ayman, Bastianon, Martina, Ferrer, Miguel, and Fontanini, Daniele Mariastefano

Abstract

The study aims to describe midterm outcomes following treatment of infrarenal abdominal aortic aneurysms (AAAs) with short necks by endosutured aneurysm repair using the Heli-FX EndoAnchor system.

Published
2024
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32. The Replicative DnaE Polymerase of Bacillus subtilis Recruits the Glycolytic Pyruvate Kinase (PykA) When Bound to Primed DNA Templates

Author

Alexandria Holland, Matthaios Pitoulias, Panos Soultanas, and Laurent Janniere

Subjects
microbiology, metabolism, replication, PykA, DnaE, moonlighting activity, Science
Abstract

The glycolytic enzyme PykA has been reported to drive the metabolic control of replication through a mechanism involving PykA moonlighting functions on the essential DnaE polymerase, the DnaC helicase and regulatory determinants of PykA catalytic activity in Bacillus subtilis. The mutants of this control suffer from critical replication and cell cycle defects, showing that the metabolic control of replication plays important functions in the overall rate of replication. Using biochemical approaches, we demonstrate here that PykA interacts with DnaE for modulating its activity when the replication enzyme is bound to a primed DNA template. This interaction is mediated by the CAT domain of PykA and possibly allosterically regulated by its PEPut domain, which also operates as a potent regulator of PykA catalytic activity. Furthermore, using fluorescence microscopy we show that the CAT and PEPut domains are important for the spatial localization of origins and replication forks, independently of their function in PykA catalytic activity. Collectively, our data suggest that the metabolic control of replication depends on the recruitment of PykA by DnaE at sites of DNA synthesis. This recruitment is likely highly dynamic, as DnaE is frequently recruited to and released from replication machineries to extend the several thousand RNA primers generated from replication initiation to termination. This implies that PykA and DnaE continuously associate and dissociate at replication machineries for ensuring a highly dynamic coordination of the replication rate with metabolism.

Published
2023
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33. Sex-Specific Analysis of Mid-Term Outcomes of Atherectomy-Assisted Endovascular Treatment in Severe Peripheral Arterial Disease.

Author

Avranas, Konstantinos, Pitoulias, Apostolos G., Taneva, Gergana T., Beropoulis, Efthymios, and Donas, Konstantinos P.

Subjects
*ENDOVASCULAR surgery, *PERIPHERAL vascular diseases, *ANKLE brachial index, *ATHERECTOMY, *POPLITEAL artery, *PROGNOSIS
Abstract

Background: Endovascular treatment of lower-extremity peripheral disease (PAD) is associated with higher complication rates and suboptimal outcomes in women. Atherectomy has shown favourable outcomes in calcified lesions, minimising the incidence of stent placement caused by recoil or flow-limiting dissection. To date, there are no published mid-term outcomes evaluating the performance of atherectomy differentiated by sex. This study aims to evaluate sex-specific outcomes and prognostic factors affecting the results of atherectomy-assisted endovascular treatment in severe PAD. Methods: A retrospective analysis was conducted at a single centre in Germany, initiated by physicians and not sponsored by industry, on patients presenting with Rutherford categories ranging from III to V and featuring de novo occlusive or stenotic lesions of the superficial femoral (SFA) and/or popliteal arteries. The intervention involved rotational atherectomy-assisted angioplasty utilising the Jetstream (Boston, US®) device. The point of interest of this study was postinterventional clinical improvement as well as mid-term outcomes, including primary patency, over a targeted 2-year follow-up period. Statistical analysis utilised Cox regression (survival analysis) to calculate hazard ratios according to sex category. Comparative survival analysis was performed using the log-rank test and visually represented through Kaplan–Meier curves. Risk factors associated with absence of clinical improvement were examined across both sex groups utilising the chi-square or Fisher exact test, as appropriate. Results: A total of 98 patients (103 limbs) were initially included, with >75% having moderate-to-severe lesion calcification (>50%). A total of 84 patients (97 limbs, 62 male and 35 female) proceeded to a 2-year follow-up (mean 16.4 months for males and 16.1 for females) after a successful index procedure. Age distribution, Rutherford class, diabetes, chronic kidney disease (CKD), target vessel, lesion type, and length were balanced among both groups. Similar primary patency rates, of 89% among female and 91% among male limbs, were observed (p = 0.471). Female patients exhibited a lower rate of clinical improvement based on the Rutherford scale in comparison to males (80.6% vs. 94.5%, p = 0.048). CDK was the only significant prognostic factor across pooled data (odds ratio for CKD: 15.15, p < 0.001). Conclusions: Rotational atherectomy showed comparably high rates of mid-term primary patency, with low rates of bailout stent placement. These findings highlight the beneficial use of atherectomy in female patients who are per se at risk for higher rates of complications during and after endovascular interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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34. The Effect of EndoAnchors on Aneurysm Sac Regression for Patients Treated With Infrarenal Endovascular Repair With Hostile Neck Anatomies: A Propensity Scored Analysis.

Author

Reyes Valdivia, Andrés, Oikonomou, Kyriakos, Milner, Ross, Kasprzak, Piotr, Reijnen, Michel M. P. J., Pitoulias, Georgios, Torsello, Giovanni B., Pfister, Karin, de Vries, Jean-Paul P. M., and Chaudhuri, Arindam

Abstract

Purpose: To analyze sac evolution patterns in matched patients with hostile neck anatomy (HNA) treated with standard endovascular aneurysm repair (sEVAR) and endosutured aneurysm repair (ESAR). Methods: Observational retrospective study using prospectively collected data between June 2010 and December 2019. ESAR group data were extracted from the primary arm of the PERU registry with an assigned identifier (NCT04100499) at 8 centers and those from the sEVAR came from 4 centers. Suitability for inclusion required: no proximal endograft adjuncts (besides EndoAnchor use), ≤15 mm neck length and minimum of 12-months follow-up imaging. Bubble-shaped neck (noncylindrical short neck with discontinuous seal) aspect was analyzed. Both groups were analyzed using propensity score matching (PSM) for aortic neck length, width, angulation, and device fixation type. Main outcome assessed was sac evolution patterns (sac expansion and regression were defined as >5mm increase or decrease, of the maximum sac diameter respectively; all AAAs within this ±5 mm range in diameter change were considered stable) and secondary outcomes were type-Ia endoleaks; other endoleaks and mortality. A power analysis calculation >80% was confirmed for sac regression evaluation. Results: After exclusions, PSM resulted in 96 ESAR and 96 sEVAR patients. Mean imaging follow-up (months) was 44.4±21.3 versus 43.0±19.6 (p=0.643), respectively. The overall number of patients achieving sac regression was higher in the ESAR group (n =57, 59.4% vs n =31, 32.3%; p<0.001) and the cumulative sac regression achieved at 5 years was 65% versus 38% (p=0.003) in favor of the ESAR group. There were no statistically significant differences in type-Ia endoleak and/or other endoleaks. Univariate analysis for sac regression patients in the sEVAR and ESAR group individually showed the bubble-shape neck as a predictor of sac regression failure. There were no statistical differences in overall and aneurysm-related mortality. Conclusion: Endosutured aneurysm repair provided improved rates of sac regression for patients with AAA and HNA when compared with sEVAR at midterm and up to 5 years, despite similar rates of type-Ia endoleaks, and the need to consider some important limitations. The presence of bubble-shaped neck was a predictor of sac regression failure for both groups equally. Clinical Impact: The use of EndoAnchors aids and improves EVAR treatment in hostile neck anatomies by an increased rate of sac regression when compared to EVAR treatment alone in up to 5 year analysis. Moreover, a trend to reduced number of type Ia endoleaks is also achieved, although not significant in the present study. This data, adds to current and growing evidence on the usefulness of EndoAnchors for AAA endovascular treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Coexisting hypogastric aneurysms worsen the outcomes of endovascular treatment by the iliac branch devices within the pELVIS Registry

Author

Austermann, Martin, Inchingolo, Mirjam, Bisdas, Theodosios, Pratesi, Giovanni, Barbante, Matteo, Cao, Piergiorgio, Ferrer, Ciro, Verzini, Fabio, Parlani, Gianbatista, Simonte, Gioele, Pratesi, Carlo, Fargion, Aaron, Masciello, Fabrizio, Kölbel, Tilo, Tsilimparis, Nikolaos, Haulon, Stephan, Branzan, Daniela, Schmidt, Andrej, Scheinert, Dirk, Donas, Konstantinos P., Taneva, Gergana T., Pitoulias, Georgios A., Torsello, Giovanni, and Veith, Frank J.

Published
2019
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40. Results of the multicenter pELVIS Registry for isolated common iliac aneurysms treated by the iliac branch device

Author

Austermann, Martin, Weiss, Kristin, Bosiers, Michel, Dorigo, Walter, Cao, Piergiorgio, Ferrer, Ciro, Ippoliti, Arnaldo, Barbante, Matteo, Pitoulias, Georgios A., Verzini, Fabio, Parlani, Gianbattista, Simonte, Gioele, Kölbel, Tilo, Tsilimparis, Nikolaos, Haulon, Stephan, Branzan, Daniela, Schmidt, Andrej, Fargion, Aaron T., Masciello, Fabrizio, Pratesi, Carlo, Pratesi, Giovanni, Torsello, Giovanni, and Donas, Konstantinos P.

Published
2018
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47. Deep vein thrombosis as the first paraneoplastic presentation of undiagnosed cancer

Author

Dimitrios A. Chatzelas, Apostolos G. Pitoulias, Zisis C. Telakis, Thomas E. Kalogirou, Maria D. Tachtsi, Dimitrios C. Christopoulos, and Georgios A. Pitoulias

Subjects
deep vein thrombosis, cancer, paraneoplastic syndrome, computed tomography, diagnosis
Abstract

Introduction: Epidemiological studies reported a mean 4-12% prevalence of unrecognized cancer in patients with unprovoked deep vein thrombosis (DVT). The objective of our study was to assess the relation between unprovoked DVT and first diagnosis of a previously undiagnosed cancer and to investigate if it is justified to routinely screen these patients for malignancy with computed tomography (CT) scan. Methods: We performed a retrospective analysis of medical records data of 276 patients with unprovoked extremity DVT admitted from 2015 to 2021. All patients underwent basic laboratory exams and a contrast enhanced CT scan of thorax, abdomen and pelvis with the purpose of screening for an occult, underlying tumor. Results: In 46 patients (16.7%) a tumor was detected with malignancy confirmed in 37 cases (13.4%). In the majority (64.8%) the diagnosed tumor was confined to the primary organ with no or limited lymph node metastasis. In 16.2% the tumor was at advanced, metastatic stage. Lung (24.3%) and kidney (21.6%) were the most frequent primary locations, followed by colorectal (16.2%) and pancreatic (13.5%) cancer. Conclusion: Patients presenting with unprovoked DVT have a relatively high possibility of an underlying malignancy, indicating that high level of medical awareness is advised. Routine screening of these patients with CT scan may be helpful for the early diagnosis of cancer. &nbsp

Published
2022
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50. Ferric quinate (QPLEX) inhibits the interaction of major outer membrane protein (MOMP) with the Lewis b (Leb) antigen and limits Campylobacter colonization in broilers

Author

Okoye, Jennifer C., primary, Holland, Alexandria, additional, Pitoulias, Matthaios, additional, Paschalis, Vasileios, additional, Piddubnyi, Artem, additional, Dufailu, Osman A., additional, Borén, Thomas, additional, Oldfield, Neil J., additional, Mahdavi, Jafar, additional, and Soultanas, Panos, additional

Published
2023
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